An Insight into Mental Health Tribunals

When a patient is detained under the Mental Health Act 1983, they maintain the right to appeal decisions about being sectioned through a mental health tribunal. This means that patients are protected from unfair detainment and have the security of knowing that they can have their case reviewed independently if they believe that they are well enough to be discharged from their section.

The following article explains what a mental health tribunal is, how a patient can apply to the tribunal and the powers that the tribunal has.

What is a mental health tribunal?

A mental health tribunal is independent of the hospital that detains and treats a patient and consists of a panel of professionals. The tribunal will assess each case presented to them separately to determine whether the patient should be detained further or discharged. All patients have the right to apply to the tribunal to have their case reviewed if they want to.

Who sits on a mental health tribunal panel?

The mental health tribunal consists of a panel of professionals who are independent to the hospital that treats a patient. Each panel will be made up of a chairperson or president who is a lawyer, a medical professional who is normally a psychiatrist and a lay person. The legal professional is the person who is in charge of the tribunal.

The patient and their responsible clinician will attend the tribunal hearing. Patients are also entitled to be joined by their closest relative if required. The patient also has the choice to avoid attendance, but if they decide not to attend the meeting, the tribunal will need to confirm that this decision was made independently and not under duress.

During the course of the tribunal, the panel evaluates each case to determine the most suitable course of action for the patients involved.

How can a patient appeal to a tribunal?

The initial phase of a mental health tribunal is the independent panel who will assess a patient's circumstances to determine whether they should continue to be detained by the hospital. The panel has the authority to discharge a patient from the Mental Health Act if they see fit. During this phase, the tribunal will meet at the hospital to assess the patient's case and decide whether the patient still meets the criteria for being sectioned or not.

Once the tribunal has assessed the individual case, they are authorised to take any of the following actions:

• Discharge the patient from their section
• Recommend that the patient gets leave
• Suggest that the patient receives supervised community treatment as opposed to hospital inpatient treatment
• Authorise a delayed discharge from the section or discharge with conditions
• Transfer the patient to a different hospital

The tribunal will meet again if their decision and recommendations are not followed to further assess the case. However, it is important to note that the hospital is not legally bound to follow the recommendations made by the mental health tribunal.

Who can apply to the mental health tribunal?

Applications to mental health tribunals should be made through the completion of a T110 form which is available to download from the Justice website, or sometimes through the hospital that treats the patient. A member of staff or an advocate should be available to help a patient fill out the form if required.

Patients who are detained under section 2, section 3 or section 37 of the Mental Health Act are entitled to apply to the mental health tribunal to appeal against sections. There are deadlines for patients to apply to tribunals which vary depending on which section of the act they are detained under:

• Section 2 - Patients who are detained under Section 2 of the Mental Health Act are required to appeal within 14 days from the beginning of their detention. The tribunal must meet within 7 days of the application being made.
• Section 3 - Patients who are detained under section 3 of the Mental Health Act are eligible to appeal the decision after 6 months of detention has passed. Following the first 6 months, patients are entitled to submit an application once in every renewal period. Section 3 detainments can be renewed every 12 months following the first six months. Tribunal hearings should sit within 8 weeks of applications being made to them by section 3 patients.
• Section 37 - Patients who are detained under section 37 are eligible to apply to appeal following six months of detention. Thereafter, patients can apply once in each renewal period which is once every 12 months. As with section 3 patients, section 37 patients should have their tribunal hearings within 8 weeks of applications being made.

Patients whose hearings are not made within the required times may be eligible to claim compensation as this can be considered as a breach of the Human Rights Act. Delays in mental health tribunal hearings breach a patient's right to a fair trial (Article 5 (4)) and as such, the patient can take legal action against the tribunal.

What happens during a mental health tribunal?

The mental health tribunal meeting takes place at the hospital where the patient is receiving treatment and aims to maintain an informal environment. The tribunal will assess each case independently, and evidence will be presented to the panel from those who work with the patient including the responsible clinician and social worker.

The panel may ask questions to those who work with the patient and will offer the patient the opportunity to also ask questions. The patient will also be afforded the opportunity to present evidence if they want to. Patients are entitled to take as many breaks as they require in order to ensure that the meeting is not too difficult and does not further impact upon their mental health.

The tribunal participants will receive a report regarding the patient before the meeting takes place. The reports usually contain details regarding the patient's medical history, a nursing report and a review of the patient's social circumstances. The medical professional of the panel will also meet with the patient before the meeting to gain a more thorough understanding of the patient's condition. However, the patient is entitled to refuse this assessment if they desire.